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Stanford Medicine 25 Blog

Dr. Mindie Nguyen Provides Advice on the Abdominal Exam

March 24, 2014

Thank you to Dr. Mindie Nguyen, one of our wonderful Stanford gastroenterologists and liver specialists, for teaching our last Stanford 25 session on the abdominal exam. Dr. Nguyen focused on practical methods of diagnosing liver and spleen enlargement. She provides us with some follow-up tips when conducting the exam of the abdomen:

“Prior to palpating organs in the abdomen, I find it useful to first ‘scout’ them out by percussion first. For the spleen, if the left lower anterior chest/upper left corner of the abdomen is resonant, the spleen is unlikely to be enlarged and I would generally move on to other parts of the abdominal exam after that. For the liver, I would also find its edge first by percussion. A few main points to remember are to “tap” your fingers more strongly, so we can better detect differences on the sounds generated by percussion and to start palpating at least 2-4 cm below the level where differences of percussion dullness starts. Asking patients to bend both their knees may also help as abdominal muscles are more relaxed in this position.”